Scalp Cooling May Reduce Hair Loss from Chemotherapy

For some cancer patients receiving chemotherapy, hair loss can be one of the most distressing side effects of treatment. Depending on the chemotherapy medication and dose, a patient can experience hair thinning to complete baldness.

To help patients deal with this distressing side effect, ProMedica Cancer Institute offers a scalp cooling system at the Hickman Cancer Center in Sylvania and the Cancer Center at Levis Commons. Scalp cooling, or scalp hypothermia, can help reduce hair loss in select patients by decreasing the amount of chemotherapy that gets to the scalp.

Scalp Cooling: How It Works

“Scalp cooling lowers the temperature of the scalp, causing blood vessels to constrict or close up, which then lessens the amount of chemotherapy that gets to the scalp and hair follicles,” explains Lisa Hartkopf Smith, advanced practice nurse, ProMedica Cancer Institute.

There are different options for scalp cooling, including frozen caps that are changed every 30 minutes throughout the treatment. Coolant machines, like those used at the two ProMedica locations, continuously circulate a coolant through a cap worn by the patient. Only coolant machines are approved for scalp hypothermia by the U.S. Food & Drug Administration (FDA).

Safe and Effective for Certain Cancers

The use of scalp cooling during chemotherapy isn’t new, but there is growing research around its effectiveness and safety. While there’s no guarantee of no hair loss, there is research supporting that it’s safe and effective for reducing hair loss for some patients.

“Oncologists and advanced practice providers look to the National Comprehensive Cancer Network, which reviews research and comes up with recommendations for cancer care,” explains Hartkopf Smith. “The network recognizes the safety and efficacy of scalp cooling for patients with breast cancer and gynecologic cancers who are receiving certain chemotherapy combinations. Gynecologic cancers include cervical, ovarian and uterine cancers.”

She adds, “Other research supports its use in men with prostate cancer receiving a chemotherapy medication called Docetaxel. Patients interested in learning if they are a candidate for scalp cooling should talk to their oncologist before they start chemotherapy.”

Tolerating the Cold

Scalp cooling is started 30 minutes before a chemotherapy session begins, as well as during and after chemotherapy is completed. The time after each treatment varies depending on the chemotherapy combination, but ranges from one to three hours.

“Scalp cooling may be uncomfortable due to the cold, but this usually subsides and becomes tolerable after the first half hour,” explains Hartkopf Smith. “We recommend that patients bring warm clothes, layers and socks. We also have a blanket warmer to keep them warm.”

Some patients may also experience headaches, scalp discomfort or nausea. The patient’s ears and forehead are protected to prevent possible damage from the cold.

This Patient’s Experience with Scalp Cooling

Linda Lindsey was diagnosed with lobular breast cancer in June of 2023. Just one week after she was diagnosed, her husband was diagnosed with lung cancer. Before starting treatment herself, she watched her husband go through treatment for his cancer. After his first round of chemotherapy, he lost all his hair.

“It was very difficult and shocking for him emotionally. You know, every time you look in the mirror you see yourself without hair and you look like a different person,” Linda shares.

Before Linda began treatment herself, she heard about scalp cooling being available at ProMedica. Although her husband wouldn’t have been eligible due to his type of cancer, Linda was. She decided to move forward with the program.

“Because of scalp cooling, I still recognize myself. Having your hair makes you feel healthy. It gives you positive thinking and the opportunity to influence your physical health with that thinking,” Linda shares.

Patients usually experience some hair loss even with scalp cooling, but it’s significantly less than without it. “A lot of my hair is still there. And when I’m done with chemotherapy, my hair will grow back quicker because of it,” Linda shares.

Regarding the cold, Linda chuckled as she used the word “intense” to describe it. “It’s very cold; it gets down to 37 degrees! But your head adjusts to it, and it gets easier as treatment goes on.”

Linda started chemotherapy in December 2023 and has 10 more treatments to go. She plans to continue cold cap therapy for the rest of them.

“I wouldn’t have thought that I would be attached to my hair, but keeping it has made me feel healthy and allowed me to choose who I share my journey with,” Linda shares. “I’m happy with the results. Scalp cooling is something I would recommend for anyone considering it.”

Paying for Scalp Cooling

More insurance companies are starting to reimburse for scalp cooling, although many still do not. At ProMedica, patients work directly with the scalp cooling company for billing and payment of the supplies and treatments.

There are also nonprofit organizations, such as Hair to Stay, Hair & Hope and Sharsheret, that help support patients and provide funds for the use of scalp cooling during chemotherapy.

Helping Patients Cope

“Hair loss can be one of the most distressing side effects that individuals experience from chemotherapy treatment. They feel like they’re losing who they are, and it may feel like the cancer is now visible. For some patients, scalp cooling therapy may lessen the impact that cancer and its treatment have on their lives,” says Hartkopf Smith.